Program & Services

Attention-Deficit/Hyperactivity Disorder

Young people with attention-deficit/hyperactivity disorder (ADHD) are usually overactive. They are not able to pay attention and can be hasty or clumsy. Children or adolescents with ADHD may not do well in school. They could even fail, even if they are very intelligent.

Hyperactive means "extra active." But that word does not tell us very much. The activity level of children who are called "hyperactive" varies. For some children, the most obvious sign may be problems paying attention. For others, the problem is hyper or impulsive behavior.

There are two groups:

• Those who are mainly hyperactive or impulsive.
• Those who have problems paying attention.

Some will could fall into both of these groups.

What causes ADHD?

There are different thoughts about what causes ADHD, but many agree the problem might have to do with brain chemicals. The signs and symptoms of this condition can appear if there are not enough of these chemicals or if they are not doing their job.

Does ADHD run in families?

Yes, ADHD does run in families. At least 30 percent to 40 percent of children with ADHD have family members with the same problem. This doesn't mean that all children in a family will have ADHD. There is usually only one child who shows the signs and symptoms in most families with ADHD.

How common is it?

ADHD is found in about one in every 20 children. About three times more boys have it than girls. Children with ADHS are at risk for many other disorders:

• About half also have a conduct disorder
• About a fourth have an anxiety disorder
• About a third have depression
• About a fifth have a learning disability

Sometimes a child will have two or more of these disorders along with ADHD. Children with ADHD might develop personality problems. They can also develop substance abuse disorders. This can happen when they are adolescents or adults.

ADHD is one reason why children are given mental health care. Boys are more likely to be put into treatment than girls. This is partly because many boys with this disorder also have a conduct disorder.

How is the diagnosis made?

Diagnosis is not easy. It can require more than one specialist. It is a mistake to make a quick diagnosis. It is not a good idea to make a diagnosis before all of the facts are known. Children should be looked at by:

• Pediatricians and/or neurologists (these doctors should have a background in behavioral and developmental problems)
• Licensed mental health professionals
• Specially trained family and general practitioners
• A team of professionals from the all of these specialties

Before diagnosing the child:

• Look at all of the possible reasons for the way a child is acting.
• Find out about other problems. These could include:
  • Learning disabilities
  • Conduct disorders
  • Depression
  • Anxiety
  • Physical illnesses
• Know about the family and classroom situation. Also know about any special conditions or problems.
• Have a good idea of the child's ability to think and how they do in school.

Physical exam

A complete exam is important. This helps rule out some medical problems. This includes a check of hearing and vision. It is also important to find out if the child has any problems with:

• Motor skills
• Memory
• Remembering things in order
• Listening and speaking
• Recognizing and repeating pictures and symbols

Learning disabilities

Children with ADHD often have learning problems. Between 40 percent and 60 percent of children with this condition have problems in school. Many others have problems doing school work. This includes writing or timed tests and is a common cause of school problems. ADHD can affect people for their whole lives.

Treatment

Common treatments include:

• Education
• Psychological approaches
• Behavioral approaches
• Medication

What help is available for families?

There are many treatments for people with ADHD. The best are medication and behavior treatments.

Medication

The drugs used most often are stimulants. These increase activity in parts of the brain that are not active enough in people with ADHD. They lessen impulsive behavior and hyper or aggressive behavior. People might respond better to one medication than to another, so please consult with a medical professional.

Antidepressants may work for some patients. Calming drugs might also work. Care must be used with all medicines as all medications have side effects.

Some children might lose weight from these medicines. They might also have a smaller appetite or could grow more slowly for a short time. Others may have trouble falling asleep. Many doctors, however, think the benefits are worth the side effects. Side effects can often be fixed by lowering the amount of the drug used.

Behavioral treatments

Behavioral treatments include:

• Teaching parents and teachers how to manage the behavior. This can include rewarding good behavior.
• A report card to connect home and school every day. For example, a parent rewarding a child for good school performance and behavior.
• Summer and Saturday programs
• Special classrooms that use behavior modification
• Specially trained classroom helpers

Stimulants and behavioral treatment can help for a few weeks or months. Research is being done on the benefits of different treatments. There is also research on new medicines.

Families might need to plan treatment or services for a child based on how bad the symptoms are and how long the symptoms last.

This plan should be developed with the family, service providers and a service coordinator or case manager.

The child is usually involved in decisions.

The support and services in a care plan is called a system of care. This system improves the child's ability to function in all areas of life and includes life at home, at school and in the community.

Adulthood

Signs and symptoms of ADHD may last into the adult years. These can include:

• Being restless
• Not being organized
• Being impulsive
• Having trouble with friends.

Adults might still:

• Be distracted easily
• Be hyper or restless
• Have mood swings (this is often the main symptom in adults)
• Not be able to finish things
• Have a bad temper (they might not be able to handle a lot of stress)
• Have problems getting along with spouses, co-workers and other people in their lives

What else can parents do?

Parents should be careful not to jump to conclusions. A child having lots of energy does not mean that he or she has ADHD. The diagnosis depends on whether the child can focus enough to finish tasks. This will probably be noticed by a teacher, and input from teachers should be taken seriously.

If parents or other caregivers think a child has ADHD, they should:

• Get the child evaluated. Check with the child's doctor for a referral to one of the following:
  • Psychiatrist
  • Psychologist
  • Child neurologist
  • Behavioral pediatrician
• Be patient if the child is diagnosed with ADHD. It might take a long time to improve.
• Let the child know that he or she is still able to do things. Recognize his or her strengths and talents. Give him or her feelings of self-worth.
• Remember that the following things can cause more problems than ADHD itself:
  • Failure
  • Frustration
  • Discouragement
  • Low self-esteem
  • Depression
• Get correct information from libraries, hotlines or other sources.
• Ask questions about treatments and services.
• Talk with other families in the community.
• Find family network organizations.

Adapted with permission from the National Mental Health Association.